Vitamins and Calcium Supplements (cont.)

Betty Kovacs, MS, RD

Betty is a Registered Dietitian who earned her B.S. degree in Food and Nutrition from Marymount College of Fordham University and her M.S. degree in Clinical Nutrition from New York University. She is the Co-Director and Director of nutrition for the New York Obesity Research Center Weight Loss Program.

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Vitamin B12

What is it, and what does it do?

Vitamin B12 is needed for producing and maintaining new cells, including nerve cells and red blood cells. It is also needed to help make DNA.

Vitamin B12 is bound to the proteins in food. Once you consume B12, the hydrochloric acid in your stomach releases the B12 from the protein. B12 then combines with a substance called intrinsic factor to be absorbed by the intestines.

How much do I need to consume?

There is insufficient information to establish an RDA for vitamin B12 for infants. In this case, an Adequate Intake (AI) has been established:

Age

Males and Females

0 to 6 months

0.4 mcg/day

7 to 12 months

0.5 mcg/day

The Recommended Dietary Allowance (RDA) for vitamin B12 is:

Age

Males and Females

Pregnancy

Lactation

1 to 3 years

0.9 mcg

N/A

N/A

4 to 8 years

1.2 mcg

N/A

N/A

9 to 13 years

1.8 mcg

N/A

N/A

14 to 19 years

2.4 mcg

2.6 mcg

2.8 mcg

19+ years

2.4 mcg/day

2.6 mcg/day

2.8 mcg/day

What are sources of vitamin B12?

Vitamin B12 is attached to the proteins in animal foods. Breakfast cereals are fortified with vitamin B12, which is very important for people who do not consume an adequate amount of animal foods.

Food

Amount

Vitamin B12

Beef, top sirloin, lean, choice, broiled

3 oz

2.4 mcg

Breakfast cereals, fortified

¾ cup

6 mcg

Chicken, breast, cooked

½ breast

0.3 mcg

Egg

1 large

0.6 mcg

Haddock, cooked

3 oz

1.2 mcg

Liver, beef

1 slice

47.9 mcg

Milk

1 cup

0.9 mcg

Mollusks, clam

3 oz

84.1 mcg

Salmon, sockeye, cooked

3 oz

4.9 mcg

Trout, rainbow, farmed, cooked

3 oz

4.2 mcg

Trout, rainbow, wild, cooked

3 oz

5.4 mcg

Tuna, white, canned in water

3 oz

1.0 mcg

Yogurt, plain, skim

1 cup

1.4 mcg

Do I need to take a vitamin B12 supplement?

Studies reveal that the majority of Americans consume an adequate amount of vitamin B12. People who do not consume meat or who have a stomach or intestinal disorder that interferes with absorption may need to take a vitamin B12 supplement. Older adults may have atrophic gastritis and may need to consume additional food sources and/or supplements. There are also some medications that can influence vitamin B12 absorption, including H2 receptor antagonists used to treat peptic ulcers, metformin, and proton pump inhibitors. Your doctor can determine your vitamin B12 levels with a blood test.

What happens if I don't have enough vitamin B12?

An inadequate amount of vitamin B12 can cause pernicious anemia. Signs of vitamin B12 deficiency are fatigue, constipation, weakness, loss of appetite, weight loss, and numbness and tingling in the hands and feet. You may also experience a difficulty in maintaining balance, confusion, dementia, depression, and poor memory. An excess intake of folate can mask the symptoms of B12 deficiency, so it's important to have your levels checked with blood tests if there is a concern, especially if you consume a vegetarian diet.

Is there such a thing as too much vitamin B12?

Currently, there is no Tolerable Upper Limit set for vitamin B12. This does not mean that consuming excessive amounts will provide any additional health benefits. It means that there is a very low potential for toxicity at high levels.